Outpatient Case Manager

4 days ago

Marietta, Georgia, United States Wellstar Health System Full time
Job Summary

Wellstar Health System is seeking a highly skilled Outpatient Case Manager to join our Population Health Management (PHM) Team. As a member of this team, you will work with patients, providers, and caregivers to provide comprehensive case management and optimize the utilization of healthcare services for patients with complex needs.

Key Responsibilities
  • Assessment
    • Review patient referrals to determine eligibility for case management
    • Conduct comprehensive assessments to identify patient and family needs
    • Identify high-risk areas, including medical, environmental, and psychosocial factors
    • Review available resources to meet client and family needs and promote optimal health and cost-effective care
  • Planning
    • Collaborate with patients, families, physicians, and multidisciplinary teams to develop and modify comprehensive, individualized plans of care
    • Integrate evidence-based clinical guidelines, preventive health guidelines, protocols, and risk information into plan development
    • Develop processes to monitor patients across the healthcare continuum, focusing on effective and safe transitions from hospital to home or other care settings
  • Implementation
    • Match patient and family needs with available resources to carry out plans of care
    • Prioritize and collaborate with patients, families, and healthcare providers to optimize patient engagement and clinical outcomes
    • Coordinate patient care services and make referrals to other team members as needed
  • Monitoring and Evaluation
    • Monitor care through data collection and analysis
    • Evaluate processes to determine the effectiveness of case management plans in achieving desired outcomes and goals
    • Manage performance feedback metrics to refine care models and maximize clinical, quality, and fiscal outcomes
Requirements
  • Graduate of an accredited school of nursing with a current Georgia RN license
  • Bachelor's degree in nursing preferred
  • Case Manager certification (CCM) preferred
  • Computer experience with Microsoft Office suite and electronic health records preferred
  • Experience in data collection and analysis, and basic research techniques desired
Preferred Qualifications
  • Knowledge of complex case management roles and processes
  • Demonstrated customer-focused interpersonal skills to interact with practitioners, multidisciplinary healthcare teams, community agencies, patients, and families with diverse backgrounds and values
  • Outgoing and autonomous personality with excellent organizational and time management skills, verbal and written communication skills, problem-solving, decision-making, priority setting, and work delegation
  • Ability to utilize risk-stratification screening criteria and review clinical data to identify patient and client healthcare needs

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